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Managing eye problems when you have diabetes

You can prevent your eye disease getting worse – but you need to act now.

If your eyesight has been damaged byretinopathy, the hard truth is, you’re at risk of losing your sight.

But taking the right steps now can stop things getting worse.

If you’ve been told you haveearly stage retinopathy, there are lots of things you can do to delay or prevent it from progressing. If it’s moreadvanced, your healthcare team will talk to you about the different treatment options.

1,600 people lose their sight every year to diabetes

Managing early stage retinopathy (background retinopathy)

All the same advice on preventing retinopathy applies here – whether you have signs of eye problems or not, managing your diabetes is critical now.

All these things can reduce your risk of more damage and so prevent or delay your eyes from getting worse. And it’s not just about eye problems, the more you do these things, the lower your risk of developing serious problems with yourfeet,heart andkidneystoo.

And you can get support with all of this, you’re not alone. We’ve made a checklist of the essential checks and services you’re entitled to when you have diabetes. These are your15 Healthcare Essentialsand they’re all free.

Treating advanced retinopathy (proliferative or maculopathy)

If your retinopathy is more advanced, you’ll need treatment or you risk losing your sight completely.

The type of treatment you have will depend on how advanced the damage is. Your healthcare team will talk to you about the treatment best for you. These will include:

We know some of these treatments may sound daunting, but the treatment is so important to save your eyesight.

And again, managing your diabetes is essential now. We keep saying this but it’s never been so important.

Laser treatment

This is the most common treatment for retinopathy. If you have this treatment and manage your blood sugar levels well, it can prevent eye damage getting worse. But it won’t usually improve your sight.

An eye specialist (called an ophthalmologist) will talk you through what’s going to happen when you have laser treatment. They’ll also tell you about any risks involved – yes, there are possibleside effectsinvolved, but the benefit to you and your eyes will outweigh the possible risks.

We’ll now give you some more information about what to expect at laser treatment, but remember you can ask your healthcare team any questions you think of.

And ask someone to go with you, so they can help you home after the treatment. You won’t usually need to stay overnight, but you may need more than one session – talk to your eye specialist about this.

What to expect when you have laser treatment

Your eye specialist will give you a local anaesthetic to numb your eyes.

They’ll give you eye drops to make your pupils bigger.

A special contact lens is then put on your eye to hold your eyelids open.

Small bursts of laser beams are focused on one part of your eye. This can feel painful, as you may feel a sharp sensation when certain areas are treated.

The treatment will take around half an hour.

After laser treatment

Most people describe feeling slightly dazzled and find their vision is affected for a short time after treatment. This should pass after a few hours.

Take sunglasses to wear afterwards as everything will look very bright.

And you won’t be able to drive or get home on your own, so you’ll need someone to help you.

Possible side effects of laser treatment

Laser treatment can cause a bit of swelling in your eye, which can make your eyesight worse. But this normally gets better in a few weeks.

If you need a few sessions, there’s a risk that your sight may be affected permanently. This is because the laser beams can affect healthy parts of the eye, as well as the unhealthy parts. Some people find it harder to see in low light, to recognise colours or they sometimes see shimmering or flashing lights.

So although these can be uncomfortable side effects, they won’t be as bad as the sight loss you could have if you don’t get the right treatment.

Eye injections

If you have maculopathy (swelling in the eye), you can have injections of a drug to treat it. This drug can slow down the damage and quickly improve your eyesight. Most people need a few injections, normally once a month.

What to expect when you have eye injections

You’ll have the injections as an outpatient, which means you won’t have to stay the night.

You’ll be given antibiotic eye drops a few days before your treatment or just before – this helps prevent an infection.

On the day, you’ll see an ophthalmologist (a doctor who specialises in eyes) who will give you numbing eye drops so the injections won’t be painful. You might find this a bit uncomfortable but it won’t hurt.

The doctor will inject your eyes with a drug called anti-VEGF.

The needle is very sharp, small and short. The injection itself only takes a few seconds and feels like a tiny scratch.

Your eye pressure is measured afterwards, to reduce any risk of further problems after the injections.

After eye injections

You don’t need to wear sunglasses after you have the injections, but you should ask someone to help you get home because your vision will be blurry for a little while. This should get better after a few hours.

Most people notice their eyesight getting better a month after their first injection. But you’ll need to go back for more injections every month, until you don’t notice any more improvements in your vision for three months. That means it’s worked and you can stop having the treatment.

You’ll still have follow-up appointments and it’s really important you go to them.

Possible side effects of eye injections

Your eye pressure may go up for a few hours and if it stays high you may need treatment to bring it down. Your healthcare team will keep a close check on this.

And you might see the medicine floating around your eye for the next few weeks. This is completely normal but can seem a little strange.

Steroids

If other treatments don’t work, steroids can help people with severe damage to their eyes. Steroids are drugs that can reduce inflammation, and so help with any swelling in your eye. Your healthcare team will explain all of this to you, but here’s some information to help you feel prepared.

What to expect when you have steroid treatment

An ophthalmologist will give you a local anaesthetic to numb the eye area.

You’ll be given antibiotic eye drops too, to help prevent infection.

The doctor then uses an injection to put a tiny implant containing the steroid into the eye.

The implant slowly releases the drug over three years.

After steroid treatment

You won’t have both eyes treated at the same time so your doctor will talk to you about when to come in for your next session.

You should notice improvements within about a month of having the implant put in. And you’ll have regular follow-up appointments with your doctor to check how the implant is working, and they may talk to you about having laser treatment as a next step

Possible side effects of steroid treatment

Your eyesight may be affected straight away so you’ll need to ask someone to help you get home.

Like all of these treatments, you may have side effects like some eye pressure, floaters in your vision and some pain in the eye. These should clear up but always let your doctor know if you’re worried about any of these.

Eye surgery

This is an operation called vitreoretinal surgery. You’ll need to stay overnight in hospital and have a general anaesthetic. This is a major procedure and can sound pretty daunting, but may be your best treatment option if you have very advanced retinopathy.

How well it works depends on a number of factors so you’ll need to speak to your eye specialist about the risks involved and what’s likely to happen afterwards.

It’s important to talk to your healthcare team if you’re worried about any of these treatments or side effects. They’ll be able to talk you through it and answer your questions.

Coping with losing your sight

Diabetes is the leading cause of preventable sight loss in the UK. That’s right, preventable. You can prevent it by going to regular eye screening, and because there are much better treatments available for both diabetes and retinopathy.

But sight loss does happen and this is extremely difficult for anyone to deal with. This is life-changing.

Many people do find a way to cope, and carry on to live happy, rewarding lives. There is expert support out there to help you through it – you’re not alone.

Talk to theRNIB(the Royal National Institute of Blind People). They are the leading source of information on sight loss and the issues affecting blind and partially sighted people. It provides a fantastic amount of help and support, includingFacebook groupsspecifically set up to your needs.

And remember, you can give our trained counsellorsa call, for more information and support, or just to chat. We’re here for you.